A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.

Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril.

Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.

Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.

Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril.

Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function.

Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.

Raloxifene is a medication used to prevent and treat osteoporosis in postmenopausal women.

Osteoporosis is a condition that causes bones to become thin and weak, increasing the risk of fractures.

Raloxifene belongs to a class of drugs called selective estrogen receptor modulators (SERMs), which mimic the effects of estrogen on bone density. Choice B is wrong because raloxifene may increase the risk of deep-vein thrombosis (DVT), a type of blood clot that forms in a vein deep in the body. DVT can cause pain, swelling, and redness in the affected limb, and can lead to serious complications such as pulmonary embolism (PE), a blood clot in the lung.

Raloxifene should not be used by people who have or had DVT or PE. Choice C is wrong because raloxifene is not used to treat urinary tract infection (UTI), an infection that affects the bladder, kidneys, or ureters. UTI can cause symptoms such as burning or pain when urinating, frequent or urgent urination, blood in the urine, or fever.

UTI is usually treated with antibiotics.

Choice D is wrong because raloxifene is not used to treat hypothyroidism, a condition that occurs when the thyroid gland does not produce enough thyroid hormone.

Thyroid hormone regulates the body’s metabolism, growth, and development. Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, or depression.

Hypothyroidism is usually treated with synthetic thyroid hormone replacement.